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i <br /> 01. <br /> :y ;e APPLICATION -- LOT LINE ADJUSTMENT <br /> T` SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> cq..---- -...ii" FILE NUMBER: --_ <br /> ----------------- <br /> li <br /> AUTHORIZATION SIGNATURES <br /> I. <br /> .I <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> :F <br /> I, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any clau im, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that i am (check one): <br /> ;I <br /> ] legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> E Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct <br /> It <br /> Print Name: j!z. WkL �1G$6 Signature: Date: — <br /> Print Name: Signature: Date:----------_-- <br /> Print Name: Signature: Date:----__------- <br /> I: <br /> Print Name: it Signature: Date:—_---_---_--- <br /> Print Name: Signature: Date: <br /> n <br /> II <br /> li <br /> u <br /> I <br /> li <br /> it <br /> .s <br /> I <br /> F,',:)EVSYCIoiannmg Application Forms`. Page o' i <br /> Let Lac Adjuslmenl dac [Revise.- <br />